Quality of life of colorectal cancer survivors in a Ghanaian population

Objective: We collected data to evaluate the quality of life of patients who have survived between one and 8 years from the diagnosis of colorectal cancer. Data description: We collected quality of life (QoL) data from colorectal patients who were diagnosed between 2009 and 2015 at the Komfo Anokye Teaching Hospital (KATH) and have survived until January 2017. The dataset consists of patients\u27 demographic data, clinicopathological characteristics, and QoL data. The validated QoL instruments for data curation was an adopted version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-CR29. The QLQ-C30 was a 30-item general cancer instrument with 5 functional subscales, and 9 symptom subscales, whereas the QLQ-CR29 was a 29-item scale that consisted of 3 functional QOL subscales and 14 symptom subscales, that are associated with colorectal cancer and its treatment. The QoL instrument was coded such that higher scores indicated increased function and better QoL, and higher symptom scores represent worse symptoms

Prevalence of pre-hypertension and hypertension and its related risk factors among undergraduate students in a Tertiary institution, Ghana

Objectives: This study sought to provide information about pre-hypertension and hypertension status among undergraduate students at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.Methods: This cross-sectional study was conducted among a total of 540 students. Participants were interviewed using questionnaires and their blood pressures (BP), height, weight were measured and Body Mass Index ‘BMI’ and Waist-to-Height Ratio (WHtR) were calculated. Repeated measurements were obtained on two successive times in students with persistently elevated BP. Data obtained was entered and analyzed using SPSS version 23. Final prevalence was adjusted for loss-to- follow up on participants with first elevated BP from the reading and logistic regression used to evaluate risk factors. P-value less than .05 was considered statistically significant.Results: Twelve (2.2%) of the students were hypertensive, whilst pre-hypertension was prevalent in 26.1% of the student. Family history of hypertension [OR = 1.68(0.73–1.68)], kidney failure [OR = 1.38(0.34– 5.60)], stroke [OR = 1.10(0.64–1.91)] and heart failure [OR = 1.03(0.27–3.94)] were associated with increased risk of developing pre-hypertension; however no significant association was observed (p > .05). WHtR and BMI were independent positively correlated with blood pressure status after controlling for gender and age (p < .05). Further analysis revealed that, obesity detected by WHtR [OR = 3.67 (1.13–11.94), p = .031] and BMI [OR = 6.89(0.71–66.48), p = .0005] were significant predictors of hypertension using logistic regression analysis.Conclusion: The study revealed considerable prevalence rates of pre-hypertension and hypertension among undergraduate students, with significant risk factors such as obesity detected by BMI and WHtR. Gender as male was also significant for pre-hypertension and hypertension. Sound prevention and control programmes of hypertension should be devised among students, to improve their knowledge and lifestyle practices early in life.Keywords: Hypertension, Pre-hypertension, Obesity, Tertiary students, Ghan

Weight management among school-aged children and adolescents: A quantitative assessment in a Ghanaian municipality

BACKGROUND: Childhood and adolescent overweight, obesity and underweight have become an issue of grave concern to both the developed and developing countries in context of global burden of non-communicable diseases. Unhealthy weight status is a significant public health issue for developing countries, of which Ghana is not excluded. This study evaluated the prevalence of overweight, obesity and underweight and its related factors among school-aged children and adolescents. METHODS: A total of 1004 participants were randomly selected from six schools. A structured questionnaire on demography and socioeconomic status of students\u27 parents/guardians was completed by the selected students. Anthropometric parameters were measured, and body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. BMI-for-age z-scores were used to categorize anthropometric data of the children as underweight, normal, overweight or obese. A cut-off value of \u3e 0.50 was used to define obesity by WHtR. RESULTS: Overweight prevalence of 13.8% and 12.6 was observed among basic school and high school students respectively based on BMI classification. Obesity prevalence of 8.8% was found in basic school students and 8.9% among high school students. Underweight was observed in 114 (11.3%) basic school students and 86 (8.6%) high school students. There was a difference in sex prevalence in unhealthy weight-behaviours; with more girls being overweight (19.4% vs 7.6%, p \u3c 0.001) and obese (10.2% vs. 7.3%, p = 0.177) compared to boys. High WHtR found in 10.5% of basic students and 5.0% of high school students, with a statistical difference. Overweight/obesity was significantly associated with taking snacks before bed among basic school students [aOR = 10.45(5.95-18)] and high school students [aOR = 10.23(5.95-18.37)] respectively. Watching TV [aOR = 0.39(0.22-0.70)], sleeping during leisure periods [aOR = 0.43(0.23-0.81)] and bicycling as a means of transport [aOR = 0.37(0.19-0.72)] to school was protective of obesity among basic school students. CONCLUSION: High prevalence of unhealthy weight-related behaviours was observed among school-aged children in the Bekwai Municipality. Snacking before bed was a major factor promoting obesity among school-aged children while leisure behaviours such as TV watching, and sleeping were protective of obesity. Therefore, it is recommended to promote and support healthy eating habits among school-aged children which are likely beneficial in reducing the risk of childhood unhealthy weight-related behaviours

Metabolic syndrome among schizophrenic patients: A comparative cross-sectional study in the middle belt of Ghana

The study determined the prevalence ofMetS in patients with schizophrenia at the Psychiatric Unit of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This comparative cross-sectional study recruited 348 schizophrenic patients comprising 236 antipsychotic-treated and 112 newly diagnosed treatment-na¨ıve patients. The MetS prevalence was assessed based on World Health Organization (WHO), International Diabetes Federation (IDF), and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria. The overall prevalence of MetS was 14.1%, 20.4%, and 23.6% using NCEP ATP III, WHO, and IDF criteria, respectively, compared to 7.8%, 3.9%, and 2.2% reported in the generalGhanaian population.The prevalence was significantly higher among treated psychiatric patients compared to treatment-na¨ıve group based on NCEP ATP III (17.8% versus 6.2%; p = 0.0001), WHO (26.2% versus 8.0%; p \u3c 0.0001), and IDF (30.3% versus 10.0%; p \u3c 0.0001). MetS was prevalent among patients on atypical antipsychotics compared to typical antipsychotics irrespective of the criteria used (i.e., 17.1% versus 11.1% for NCEP ATP III; 29.5% versus 25.9% for WHO; and 44.3% versus 18.5% for IDF). Using logistic regression model, obesity, raised fasting blood sugar, raised total cholesterol, and decreased high density lipoprotein were observed to be significant predictors of MetS (p\u3c0.05).The study found high prevalence of MetS in Ghanaians with schizophrenia and higher prevalence rate of MetS associated with monotherapy. Regular monitoring of cardiometabolic parameters should be an important therapeutic objective in the management of these patients

Colorectal cancer survival rates in Ghana: A retrospective hospital-based study

BACKGROUND: Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana. METHODOLOGY: In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained using the Kaplan-Meier method and compared by the Log-rank test. Cox regression analysis was used to assess prognostic factors. All analyses were performed by SPSS version 22. RESULTS: The median survival time was 15 months 95% CI (11.79-18.21). The overall survival rate for CRC over the 5 years period was 16.0%. The survival rates at the 1st, 2nd, 3rd, 4th and 5th years were 64% 95% CI (56.2-71.1), 40% 95% CI (32.2-50.1), 21% 95% CI (11.4-30.6) 16% 95% CI (8.9-26.9) and 16% 95% CI (7.3-24.9). There was a significant difference in the survival rate of colorectal cancer according to the different stages (p = 0.0001). Family history [HR = (3.44), p = 0.029)], Chemotherapy [HR = (0.23), p = CONCLUSION: The study has clearly demonstrated that survival rate for CRC patients at KATH, Ghana is very low in a 5 years period. This is influenced by significant number of clinical and pathological prognostic factors. Identification of prognostic factors would be a primary basis for early prediction and treatment of patients with colorectal cancer

Association of wrist circumference and waist-to-height ratio with cardiometabolic risk factors among type II diabetics in a Ghanaian population

The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39–6.72), ] and systolic blood pressure [aOR = 2.08 (1.17–3.68), ]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10–3.82), ] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34–111.4), ] and WHtR [aOR = 2.52 (0.42–15.02), ] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years. The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of CRFs

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia among Ghanaian men: a hospital-based cross-sectional prospective study

Background: Lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) are common in the elderly. This study sought to determine the prevalence of LUTS among patients visiting the urology clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana and to explore its presentation patterns.Methods: Simple randomized sampling technique was used to recruit 225 subjects with a mean age of 67.96±14.57 (range=40-100years) in a prospective cross-sectional study. LUTS related characteristics and international prostate symptom score (IPSS) questionnaire were employed to obtain relevant data.Results: The average IPSS of the studied participants was 17.52±7.83. Based on the IPSS, the prevalence of LUTS suggestive of BPH was 88.89%. Bladder storage symptoms were also recorded at 88.59% whilst prostate enlargement based on digital rectal examination (DRE) was 60.4% among the studied subjects.  PSA levels ≥4.0ng/ml gave a prevalence of 81.5%. The prevalence of prostate enlargement defined as PSA ≥1.5ng/ml was 85.23% among the studied subjects whilst 63.11% of the subjects examined had troublesome LUTS. Urgency was the most predominantly reported LUTS (93.3%) among the subjects studied.Conclusions: This study has clearly shown that, the most prevalent urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia were bladder storage symptoms and urgency. These symptoms when present clinically therefore, suggest benign prostatic hyperplasia and that the prevalence estimates of LUTS in older men are relatively higher at diagnosis.

Developing a modified low-density lipoprotein (M-LDL-C) Friedewald’s equation as a substitute for direct LDL-C measure in a Ghanaian population: a comparative study

Despite the availability of several homogenous LDL-C assays, calculated Friedewald\u27s LDL-C equation remains the widely used formula in clinical practice. Several novel formulas developed in different populations have been reported to outperform the Friedewald formula. This study validated the existing LDL-C formulas and derived a modified LDL-C formula specific to a Ghanaian population. In this comparative study, we recruited 1518 participants, derived a new modified Friedewald\u27s LDL-C (M-LDL-C) equation, evaluated LDL-C by Friedewald\u27s formula (F-LDL-C), Martin\u27s formula (N-LDL-C), Anandaraja\u27s formula (A-LDL-C), and compared them to direct measurement of LDL-C (D-LDL-C). The mean D-LDL-C (2.47±0.71 mmol/L) was significantly lower compared to F-LDL-C (2.76±1.05 mmol/L), N-LDL-C (2.74±1.04 mmol/L), A-LDL-C (2.99±1.02 mmol/L), and M-LDL-C (2.97±1.08 mmol/L) p \u3c 0.001. There was a significantly positive correlation between D-LDL-C and A-LDL-C (r=0.658, p\u3c0.0001), N-LDL-C (r=0.693, p\u3c0.0001), and M-LDL-C (r=0.693, p\u3c0.0001). M-LDL-c yielded a better diagnostic performance [(area under the curve (AUC)=0.81; sensitivity (SE) (60%) and specificity (SP) (88%)] followed by N-LDL-C [(AUC=0.81; SE (63%) and SP (85%)], F-LDL-C [(AUC=0.80; SE (63%) and SP (84%)], and A-LDL-C (AUC=0.77; SE (68%) and SP (78%)] using D-LDL-C as gold standard. Bland-Altman plots showed a definite agreement between means and differences of D-LDL-C and the calculated formulas with 95% of values lying within ±0.50 SD limits. The modified LDL-C (M-LDL-C) formula derived by this study yielded a better diagnostic accuracy compared to A-LDL-C and F-LDL-C equations and thus could serve as a substitute for D-LDL-C and F-LDL-C equations in the Ghanaian population

Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study

Abstract Background Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. Method This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. Results Out of a total of 630 participants, 325 (51.5 %) knew diabetic foot as the most common complication followed by hypertension 223(35.4 %), neuropathy 184 (29.2 %), hypoactive sexual arousal 160(25.4 %), arousal disorder 135(21.5 %), eye diseases 112(17.7 %), heart disease 58(9.2 %), and renal disease 34(5.4 %). Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 %) of T2D patients did not have knowledge on diabetes complications, 169(26.9 %) had inadequate knowledge on diabetics complication while 82(13.1 %) had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR) =2.31 (1.56–3.41) married participants AOR = 3.37 (1.44–7.93), widowed AOR = 2.98 (1.10–8.08), basic level of education AOR =0.18 (0.082–0.50), Junior High School (JHS) and above of education level AOR = 0.035(0.017–0.75), 5–9 years of T2D duration AOR = 0.31(0.018–0.57), ≥10 years T2D duration AOR = 0.042 (0.02–0.10) and urban dwellers AOR = 0.36 (0.22–0.68) respectively. Conclusion Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum of education can improve self-regulatory awareness of diabetic complications which may reduce the morbidity and mortality of diabetic patients

Colorectal cancer survival rates in Ghana: A retrospective hospital-based study.

BACKGROUND:Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana. METHODOLOGY:In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained using the Kaplan-Meier method and compared by the Log-rank test. Cox regression analysis was used to assess prognostic factors. All analyses were performed by SPSS version 22. RESULTS:The median survival time was 15 months 95% CI (11.79-18.21). The overall survival rate for CRC over the 5 years period was 16.0%. The survival rates at the 1st, 2nd, 3rd, 4th and 5th years were 64% 95% CI (56.2-71.1), 40% 95% CI (32.2-50.1), 21% 95% CI (11.4-30.6) 16% 95% CI (8.9-26.9) and 16% 95% CI (7.3-24.9). There was a significant difference in the survival rate of colorectal cancer according to the different stages (p = 0.0001). Family history [HR = (3.44), p = 0.029)], Chemotherapy [HR = (0.23), p = <0.0001)], BMI [HR = (1.78), p = 0.017)] and both chemo/radiotherapy (HR = (3.63), p = 0.042)] were the significant social and clinical factors influencing the overall survival. Pathological factors such as TNM tumour stage (p = 0.012), depth of tumour invasion (p = 0.036), lymph node metastasis (p = 0.0001), and distance metastasis (p = 0.001) were significantly associated with overall survival. CONCLUSION:The study has clearly demonstrated that survival rate for CRC patients at KATH, Ghana is very low in a 5 years period. This is influenced by significant number of clinical and pathological prognostic factors. Identification of prognostic factors would be a primary basis for early prediction and treatment of patients with colorectal cancer